Contract - Elliot Electric - 7/23/2020CITY OF ROUND ROCK AGREEMENT FOR
PURCHASE OF BUILDING MAINTENANCE,
REPAIR, OPERATIONS AND EQUIPMENT
WITH
ELLIOTT ELECTRIC SUPPLY
THE STATE OF TEXAS §
CITY OF ROUND ROCK §
COUNTY OF WILLIAMSON §
COUNTY OF TRAMS §
KNOW ALL BY THESE PRESENTS:
THAT THIS AGREEMENT for the purchase of building maintenance, repair, operations
and equipment, and for related goods and services (referred to herein as the "Agreement"), is
made and entered into on this the 4 day of the month of IR , 2020 b and
��. y y
between the CITY OF ROUND ROCK, a Texas home -rule municipality, whose offices are
located at 221 East Main Street, Round Rock, Texas 78664-5299 (referred to herein as the
"City"), and ELLIOTT ELECTRIC SUPPLY, whose address is 12555 Harris Branch Parkway
# 105, Manor, Texas 78653 (referred to herein as "Vendor").
RECITALS:
WHEREAS, City desires to purchase certain goods and services related to building
maintenance, repair, operations and equipment, and City desires to procure same from Vendor;
and
WHEREAS, City is a member of Buy Board Cooperative Purchasing Program ("Buy
Board") and Vendor is an approved Buy Board vendor through Buy Board Contract #577-18;
and
WHEREAS, City desires to purchase said goods and services from Vendor through Buy
Board as set forth herein; and
WHEREAS, the parties desire to enter into this Agreement to set forth in writing their
respective rights, duties, and obligations;
NOW, THEREFORE, WITNESSETH:
That for and in consideration of the mutual promises contained herein and other good and
valuable consideration, the sufficiency and receipt of which are hereby acknowledged, it is
mutually agreed between the parties as follow:
004456661/ss2
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1.01 DEFINITIONS
A. Agreement means the binding legal contract between City and Vendor whereby
City is obligated to buy specified services and Vendor is obligated to provide said services. The
Agreement includes Vendor's discounts off catalog pricing (attached as Exhibit "A").
B. City means the City of Round Rock, Williamson and Travis Counties, Texas.
C. Effective Date means the date upon which the binding signatures of both parties
to this Agreement are affixed.
D. Force Ma*Jeure means acts of God, strikes, lockouts, or other industrial
disturbances, acts of the public enemy, orders of any kind from the government of the United
States or the State of Texas or any civil or military authority, insurrections, riots, epidemics,
landslides, lightning, earthquakes, fires, hurricanes, storms, floods, restraint of the government
and the people, civil disturbances, explosions, or other causes not reasonably within the control
of the party claiming such inability.
E. Goods mean the specified supplies, materials, commodities, or equipment.
F. Services mean work performed to meet a demand or effort by Vendor to comply
with promised delivery dates, specifications, and technical assistance specified.
2.01 EFFECTIVE DATE, TERM, PRICES FIRM
A. This Agreement shall be effective on the date this Agreement has been signed by
each party hereto, and shall remain in full force and effect unless and until it expires by operation
of the term indicated herein, or is terminated or extended as provided herein.
B. This Agreement shall terminate November 30, 202 1.
co City reserves the right to review the relationship with Vendor at any time, and
may elect to terminate this Agreement with or without cause or may elect to continue.
3.01 CONTRACT DOCUMENTS AND EXHIBITS
.The goods and services which are the subject matter of this Agreement are described in
Exhibit "A" and, together with this Agreement, comprise the Contract Documents.
4*0 1 ITEMS
A. This Agreement shall evidence the entire understanding and agreement between
the parties and shall supersede any prior proposals, correspondence or discussions.
B. Vendor shall satisfactorily provide all deliverables described in Exhibit "A"
within the contract term s
pecified. A change in the Scope of Services or any term of this
2
Agreement, including bonding requirements, must be negotiated and agreed to in all relevant
details, and must be embodied in a valid Supplemental Agreement as described herein.
5.01 COSTS
A. City agrees to pay for supplies during the term of this Agreement at the pricing set
forth at in Exhibit "A." Vendor specifically acknowledged and agrees that City is not obligated
to use or purchase any estimated annual quantity of goods. Only if, and when needed by City,
the costs listed on Exhibit "A" shall be the basis of any charges collected by Vendor.
B. The City shall be authorized to pay the Vendor an amount not -to -exceed One
Hundred Fifty Thousand and NO/100 Dollars ($150,000.00) for the term of this Agreement,,
6.01 INVOICES
All invoices shall include, ataminimum, the following information:
A. Name and address of Vendor;
B. Purchase Order Number;
C. Description and quantity of items received or services provided; and
D. Delivery or Pferormance dates.
7.01 NON -APPROPRIATION AND FISCAL FUNDING
This Agreement is a commitment of City"s current revenues only. It is understood and
agreed that City shall have the right to terminate this Agreement at the end of any City fiscal year
if the governing body of City does not appropriate funds sufficient to purchase the services as
determined by City's budget for the fiscal year in question. City may effect such termination by
giving Vendor a written notice of termination at the end of its then current fiscal year.
8.01 PROMPT PAYMENT POLICY
In accordance with Chapter 2251, V.T.C.A., Texas Government Code, payment to
Vendor will be made within thirty (30) days of the day on which City receives the performance,
supplies, materials, equipment, and/or deliverables, or within thirty (30) days of the day on
which the performance of services was complete, or within thirty (30) days of the day on which
City receives a correct invoice for the performance and/or deliverables or services, whichever is
later. Vendor may charge interest on an overdue payment at the " rate in effect " on September 1
of the fiscal year in which the payment becomes overdue, in accordance with V.T.C.A., Texas
Government Code, Section 2251.025(b); however, this Policy does not apply to payments made
by City in the event:
A. There is a bona fide dispute between City and Vendor,, a contractor, subcontractor
or supplier about the goods delivered or the service performed that cause the
payment to be late; or
B. The terms of a federal contract, grant, regulation, or statute prevent City from
11
making a timely payment with federal funds; or
C. There is a bona fide dispute between Vendor and a subcontractor or between a
subcontractor and its supplier about the goods delivered or the service performed
that causes the payment to be late; or
D. Invoices are not mailed to City in strict accordance with instructions, if any, on
the purchase order or the Agreement or other such contractual agreement,,
9.01 GRATUITIES AND BRIBES
City may, by written notice to Vendor, cancel this Agreement without liability to Vendor
if it is determined by City that gratuities or bribes in the form of entertainment,, gifts, or
otherwise were offered or given by Vendor or its agents or representatives to any City officer,
employee or elected representative with resioectpto the performance of this Agreement. In
addition, Vendor may be subject to penalties stated in Title 8 of the Texas Penal Code.
10.01 TAXES
City is exempt from Federal Excise and State Sales Tax; therefore, tax shall not be
iincludedn Vendor's charges.
11.01 ORDERS PLACED WITH ALTERNATE SERVICES PROVIDERS
If Vendor cannot provide the goods as specified, City reserves the right and option to
40
obtain the products from another supplier or suppliers
12.01 CITY'S REPRESENTATIVE
City hereby designates the following representative authorized to act in its behalf with
regard to this Agreement:
Chad McDowell
Director of General Services
212 Commerce Cove
Round Rock, Texas 78664
(512) 341-3191
cmcdowellgroundrocktexas.gov
4
13.01 INSURANCE
Vendor shall meet all City of Round Rock Insurance Requirements as set forth at:
httD://www.roundrocktexas.�ov/wp-content/uploads/2014/12/corr- insurance 07.201.12.pdf
14.01 RIGHT TO ASSURANCE
Whenever either party to this Agreement, in good faith, has reason to question the other
patty's intent to perform hereunder, then demand may be made to the other party for written
assurance of the intent to perform. In the event that no written assurance is given within the
reasonable time specified when demand is made, then and in that event the demanding party may
41
treat such failure as an anticipatory repudiation of this Agreement.
15.01 DEFAULT
If Vendor abandons or defaults under this Agreement and is a cause of City purchasing
the specified goods elsewhere, Vendor agrees that it may be charged the difference in cost, if
any, and that it will not be considered in the re -advertisement of the service and that it may not
be considered in future bids for the same type of work unless the scope of work is significantly
changed.
Vendor shall be declared in default of this Agreement if it does any of the following:
A. Fails to fully, timely and faithfully perform any of its material obligations
under this Agreement;
B. Fails to provide adequate assurance of performance under the "Right to
Assurance" section herein; or
C. Becomes insolvent or seeks relief under the bankruptcy laws of the United
States.
16.01 TERMINATION AND SUSPENSION
A. City has the right to terminate this Agreement, in whole or in part, for
convenience and without cause, at any time upon thirty (30) days' written notice to Vendor.
B. In the event of any default by Vendor, City has the right to terminate this
Agreement for cause, upon ten (10) dayswritten notice to Vendor.
C. Vendor has the right to terminate this Agreement only for cause, that being in the
event of a material and substantial breach by City, or by mutual agreement to terminate
evidenced in writing by and between the parties.
D. In the event City terminates under subsections (A) or (B) of this section, the
41
following shall anply: Upon City's delivery of the referenced notice to Vendor, Vendor shall
discontinue all services in connection with the performance of this Agreement and shall proceed
5
to cancel promptly all existing orders and contracts insofar as such orders and contracts are
chargeable to this Agreement. Within thirty (30) days after such notice of termination, Vendor
shall submit a statement showing in detail the goods and/or services satisfactorily performed
under this Agreement to the date of termination. City shall then pay Vendor that portion of the
charges, if undisputed. The parties agree that Vendor is not entitled to compensation for services
it would have performed under the remaining term of the Agreement except as provided herein.
17.01 INDEMNIFICATION
Vendor shall defend (at the option of City), indemnify, and hold City, its successors,
assigns, officers, employees and elected officials harmless from and against all suits, actions,
legal proceedings, claims, demands, damages, costs, expenses, attorneys fees, and any and all
other costs or fees arising out of, or incident to, concerning or resulting from the fault of Vendor,
or Vendor's agents, employees or subcontractors, in the performance of Vendor's obligations
under this Agreement, no matter how, or to whom, such loss may occur. Nothing herein shall be
deemed to limit the rights of City or Vendor (including, but not limited to the right to seek
contribution) against any third party who may be liable for an indemnified claim.
18.01 COMPLIANCE WITH LAWS, CHARTER AND ORDINANCES
A. Vendor, its agents, employees and subcontractors shall use best efforts to comply
with all applicable federal and state laws, the Charter and Ordinances of the City of Round Rock,
as amended, and with all applicable rules and regulations promulgated by local, state and
national boards, bureaus and agencies.
B. In accordance with Chapter 2270, Texas Government Code, a governmental entity
may not enter into a contract with a company for goods or services unless the contract contains
written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott
Israel and will not boycott Israel during the term of this contract. The signatory executing this
Agreement on behalf of Vendor verifies Vendor does not boycott Israel and will not boycott
Israel during the term of this Agreement.
19.01 ASSIGNMENT AND DELEGATION
The parties each hereby bind themselves, their successors, assigns and legal
representatives to each other with respect to the terms of this Agreement. Neither party shall
assign, sublet or transfer any interest in this Agreement without prior written authorization of the
other party.
20.01 NOTICES
All notices and other communications in connection with this Agreement shall be in
writing and shall be considered given as follows:
1. When delivered personally to the recipient's address as stated in this Agreement;
or
6
2,9 Three (3) days after being deposited in the United States mail, with postage
prepaid to the recipient's address as stated in this Agreement.
Notice to Vendor:
Elliott Electric Supply
12555 Harris Branch Parkway #105
Manor, Texas 78653
Notice to City:
City Manager
221 East Main Street
Round Rock, TX 78664
Stephan L. Sheets, City Attorney
AND TO: 309 East Main Street
Round Rock, TX 78664
Nothing contained herein shall be construed to restrict the transmission of routine
communications between representatives of City and Vendor.
21.01 APPLICABLE LAW; ENFORCEMENT AND VENUE
This Agreement shall be enforceable in Round Rock, Texas, and if legal action is
necessary by either party with respect to the enforcement of any or all of the terms or conditions
herein, exclusive venue for same shall lie in Williamson County, Texas. This Agreement shall be
40
governed by and construed in accordance with the laws and court decisions of the State of Texas.
22.01 EXCLUSIVE AGREEMENT
This document, and all appended documents, constitutes the entire Agreement between
Vendor and City. This Agreement may only be amended or supplemented by mutual agreement
of the parties hereto in writing, duly authorized by action of the City Manager or City Council.
23.01 DISPUTE RESOLUTION
City and Vendor hereby expressly agree that no claims or disputes between the parties
arising out of or relating to this Agreement or a breach thereof shall be decided by any arbitration
proceeding, including without limitation, any proceeding under the Federal Arbitration Act (9
USC Section 1-14) or any applicable state arbitration statute,,
24.01 SEVERABILITY
The invalid41 ity, illegality, or unenforceabiltyiof any provision of this Agreement or the
occurrence of any event rendering any portion or provision of this Agreement void shall in no
way affect the validity or enforceability of any other portion or provision of this Agreement. Any
void provision shall be deemed severed from this Agreement, and the balance of this Agreement
shall be construed and enforced as if this Agreement did not contain the particular portion or
provision held to be void. The parties further agree to amend this Agreement to replace any
stricken provision with a valid provision that comes as close as possible to the intent of the
stricken provision. The provisions of this section shall not prevent this entire Agreement from
being void should a provision which is of the essence of this Agreement be determined void.
25.01 MISCELLANEOUS PROVISIONS
Standard of Care. Vendor represents that it employs trained, experienced and
competent persons to perform all of the services, responsibilities and duties specified herein and
that such services, responsibilities and duties shall be performed in a manner according to
generally accepted industry practices.
Tiimes of the Essence. Vendor understands and agrees that time is of the essence and
that any failure of Vendor to fulfill obligations for each portion of this Agreement within the
agreed timeframes will constitute a material breach of this Agreement. Vendor shall be fully
49
responsible for its delays or for failures to use best efforts in accordance with the terms of this
49
Agreement. Where damage is caused to City due to Vendor's failure to perform in these
circumstances, City may pursue any remedy available without waiver of any of Ci'ty's additional
legal rights or remedies.
Force Maj*eure. Neither City nor Vendor shall be deemed in violation of this Agreement
41
if it is prevented from performing any of its obligations hereunder by reasons for which it is not
responsible as defined herein. However, notice of such impediment or delay in performance must
be timely given and all reasonable efforts undertaken to mitigate its effects.
Multiple Counterparts. This Agreement may be executed in multiple counterparts, any
one of which shall be considered an original of this document; and all of which, when taken
together, shall constitute one and the same instrument.
[Signatures on the following page.]
IN WITNESS WHEREOF, City and Vendor have executed this Agreement on the dates
indicated.
City of Round Rq�Ck, Texas
By:
Printed Name:
Title: I
Date Signed: _
Attest:
By: wp.-
Sara L. White, City Clerk
For City, p roved as to F rm:
By:
Stephan . Sheets, City Attorney
Elliott Electric Supply
By:
Printed Name:110
A.�..sS
Title:
Date Signed: 5,—1 1 — 2�
t=Xt111)1t "H"
City of Round Rock, Texas
Price Sheet
Elliott Electiric Supply
BuyBoard Contract 577-18
The City of Round Rock would
like to enter into a contract with Elliott Electric Supply per the terms of Buy Board Contract 577-18. The City intends to purchase
from this contract Building Maintenance, Repair and Operations Supplies and Equipment in a total amount not to exceed $150k
Contract Term: Effective from date of execution and will expire on 11/30/2021, per the terms of BuyBoard Contract No. 577-18
Special Instructions: Complete pricing below and submit copy of price list or catalog.
Section I,* BuildingMaintenance, Repair and Operations Supplies and Equipment
Item #
Short Description
Full Description
State Percent (%) of Discount
of Catalo,g/Pricelist
State Name of
Catalo /Pricelist
Exceptions to Discount
Please state the discount (%) off
Discount (%) Off
catalog/pricelist for Electrical
Catalog/Pricelist for
Supplies, Materials and Equipment.
Sp/o
Electrical Supplies,
Catalog/Pricelist MUST be
Materials and
included or proposal will not be
1
Equipment
considered
elliott _electric _577-18
Please state the discount (%) off
Discount (%) Off
catalog/pricelist for Various Types of
Catalog/Pricelist for
Lamps and Ballasts. Catalog/Pricelist
81%
Various Types of
MUST be included or proposal will not be
3
Lamps and Ballasts
considered
elliott electric 577-18
Discount (%) Off
Please state the discount (%) off
Catalog/Pricelist for
catalog/pricelist for All Types of
All Types of Fasteners
Fasteners and Hardware Productst.
15%
and
Catalog/Pricelist MUST be included or
10
Hardware Products
proposal will not be considered
elliott electric 577-18
Please state the discount (%) off
Discount Off
catalog/pricelist for Ehand Tools.
Catalog/Pricelist for
Catalog/Pricelist MUST be
30%
Hand Tools
included or proposal will not be
19
considered
elliott.,.,.electric-5-77-181
Information Only: The City of Round Rock reserves the right to order other products from the attached MSRP Sheet per the discounts quoted in BuyBoard Contract #S24-
COMPANY NAME:
Elliott Electric Supply
s� ui4 A i urcr yr
e,
A T TTTW1R T71PTl
PRINTED NAME:
Kody King
PHONE NUMBER:
512-246-8001
EMAIL ADDRESS:
kodvkinEa�eiiiottelec:rri'c.cc>ri,
AC<:)0Rbr CERTIFICATE OF LIABILITY INSURANCE
-00
DATE (MM/DDIYYYY)
5/11/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
BXS Insurance
3310 N . University Drive
Nacogdoches TX 75965M
INSURED
Elliott Electric Supply, Inc.
P. O. Box 630610
Nacogdoches TX 75963m061 0
CONTACT
NAME: Denise Moreau
PraCO�, No Ex0; 936-564-0221----------------- -1 FAX Now-- -
E-MAIL
ADDRESS: denise.moreauabxsi.com
INSURER(S) AFFORDING COVERAGE
INSURER A_ Hartford_ Casualty Insurance Company
ELLIELE-01 ENSURER B : Hartford Underwriters Insurance Company___
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 2014520307 REVISION NUMBER:
NAIC #
29424
30104
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
PAID CLAIMS.-_
EXCLUSIONS AND CONDITIONS OF SUCH POLIINSDCIES.WVD LIMITS SHOWN MAY HAVE BEEN REDUCED BICY
EFFY
INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER(MM/DDIYYYY)mwwdh��LPOLICYEXP/YYYY LIMITS
LTR
B
X
COMMERCIAL GENERAL LIABILITY
61 UENHN2347
12/25/2019
12/25/2020
EACH OCCURRENCE
$19000,000
CLAIMS -MADE XOCCUR
I
DAMAGE TO RENTED
PREMISES(Ea_
$500,000--occurrence)
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$190009000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 27000,000
POLICY � JECT � LOC
$2,000,000 ____
X
PRODUCTS __COMP/OP AGG
OTHER:
$
A
AUTOMOBILE LIABILITY
61UENHN0108
12/25/2019
12/25/2020
Ea aBcldeDtSINGLE LIMIT
$1,000,000
BODILY INJURY (Per person)
X AiJ'a' ALTO
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
$
BODILY INJURY (Per accident)
X HIRED x NON -OWNED
AUTOS ONLY AUTOS ONLY
�
PROPERTY DAMAGE
Per accident___
$
A
X
UMBRELLA LIAR
X
OCCUR
61 RHUHH8068
12/25/2019
12/25/2020
EACH OCCURRENCE
$10,000,000
EXCESS LWB
CLAIMS -MADE
AGGREGATE
$ 10,000,000
DED X LRETENTION $
$
q
WORKERS COMPENSATION
ANDEMPLOYERS' LIABILITY Y � N
ANYPR4PRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? �
N / A
61WBAC2SSM
12/25/2019
i
�
12/25/2020
X PER i OTH-
__ STATUTE ER_
E.L. EACH ACCIDENT
---- -�-
! $ 1,000,000
---- - -
---- --- -- -
E.L. DISEASE --EA EMPLOYEE
(Mandatory in NH)
$11000V000
If yes, describe under
DESCRIPTION OF OPERATIONS below
�-
E.L. DISEASE -POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
City of Round Rock
221 East Main Street
Round Rock TX 78664
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988=2015 ACORD CORPORATION. All rights reserved,.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
-
R,IFICAT.OFIN`..".^`.`".~ , ^,.'
FORM 1295
I&I
Complete Nos. 1 -m 4 and 6 if there are interested pardesS OFFICE USE ONLY
Complete Nos,, 1, 21 31 5. and 6 if there are no interested pafties.. CERTIFICA ON OF FILING
- ---------- ------- --------- - -- --- - -- --- - --- --------------- ------- - - -----------
'wty, s e and coun" of the business ity*
1 Name of business entity filing form, and the ci O!nt' s place Certificate Number.
of business, 2020v,643970
Elliott Electric Supply, lnc,,
Nacogdoches, TX United States Date Filed,
------ ---- - -------------------------------- --------- ----- - -------- ----- - --- --- - -- --- ------------- - - -- - ----- ---
WWWWWWON h the form is 07/14/2020
2 Nam'e of governmentW entt� or state agency that is a party to the contract f r whic
being filed,
Date Acknowiedged.,
Cfty of Round Rock
---------- ---
3 Provide the identification number used by the govemmental entity or state agency to track or identify the contract and provide a
Aeswiption of the services, goods, or other property to be proVided under the contract
Buy Board Contract 577w18
Building Maintenance, Repair and Operabons Supplies and Equipment
--------- -------------------------- - - ------------------------------- - -- - ------------ --------------- WNWN ---------- - ----- - -- WIN! NO NN ----- ---------- - --- - -----------------
----------- -
Nature of interest
4
Name of Interested Party City, State, Country (place of business) (check applicable)
- ----- -- --------- ---- ---------------- NW-M-N -------------------- Controll.ing
------- ---------------------- - ------ - - - - - -----------
Inte ediary
NOW --- ----------
Elliotts Bill Nacogdoches, TX United States X
---------
El jotts Billy Nacogdoches, TX United States X
Flores Robert Nacc)gdodhes, TX United States X
------- --- ---- - -------- - -- -- ---------- --- ----
lb 1p
. Check ``.-^-```'.^^�^`.''.' '
'
------ - --- ------------- ------ ---------------- MUNNOWN-M ------ - ----- ------
' UNSWORN DECLARATION-W
'
my name is Robert A. Flores and my date of birth 'I's
My address is TX I's ANG2000061^759630 ..I USA w
(efty) (state) (zip code) (country)
I declare undepenafty of perjury that the foregoing is true and correct.
Executed in Nacogdoches County, State ofon the I 4th day of J y1y," 2020- --------- - ------- - ---
__
(month) (year)
Signature of authodzed agent rcontracting business -..fty(Declarant) I
Forms prov'ided by Texas Ethics Commission -,Vw-m,ethics.,.state,'U,.US ...Versi*on.,,..V.l,l,,3a6aaf7.,,.d..,
_
. `'
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
10fi
Complete Nos, 1 w 4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos., 1, 21 31 5, and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number:
of business. 2020-643970
Elliott Electric Supply, Inc.
Nacogdoches, TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 07/14/2020
being filed.
City of Round Rock Date Acknowledged:
07/16/2020
g Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
Buy Board Contract 57748
Building Maintenance, Repair and Operations Supplies and Equipment
4 Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
Elliott, Bill
Nacogdoches, TX United States
X
Elliott, Billy
Nacogdoches, TX United States
X
Flores, Robert
Nacogdoches, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is ,and my date of birth is
My address is -�l -
(street) (city) (state) (zip code) (country)
declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of , on the day of , 20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www,ethics.state,tx,us Version V1,1.3a6aaf7d